| Lake Odessa Dental Associates | |
|
1032 4th Ave Lake Odessa MI 48849-1004 | |
| (616) 374-8828 | |
| (616) 374-7934 |
| Full Name | Lake Odessa Dental Associates |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1032 4th Ave, Lake Odessa, Michigan |
| Authorized Official Name and Position | Michael Joseph Crete (MEMBER) |
| Authorized Official Contact | 6165603625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Odessa Dental Associates 2101 San Lu Rae Dr Se Grand Rapids MI 49506-3425 Ph: (616) 560-3625 | Lake Odessa Dental Associates 1032 4th Ave Lake Odessa MI 48849-1004 Ph: (616) 374-8828 |
| NPI Number | 1851889471 |
|---|---|
| Provider Enumeration Date | 04/30/2018 |
| Last Update Date | 04/30/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851889471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Gerald T Licari Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1032 4th Ave, Lake Odessa, MI 48849 Phone: 616-374-8828 | |
Alex T. Hoelzel, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1032 4th Ave, Lake Odessa, MI 48849 Phone: 616-374-8828 |